Healthcare Provider Details
I. General information
NPI: 1811774565
Provider Name (Legal Business Name): WAYSTONE HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/14/2023
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 CENTRE DR STE 102
STEPHENS CITY VA
22655-4073
US
IV. Provider business mailing address
104 MAVERICK CT
STEPHENS CITY VA
22655-4833
US
V. Phone/Fax
- Phone: 540-227-0043
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALEJANDRO
GONZALEZ
Title or Position: OWNER / PHYSICAL THERAPIST
Credential: DPT
Phone: 540-227-0043